what's driving off the fiscal cliff make us look like? it makes us look completely irresponsible as if we can't control our own spending and put in order some priorities. >> so there will be some real health care suffering if we go off the cliff, so to speak? >> that's absolutely true. i would say the other important thing we need to do, we want to incentivize doctors an hospitals to keep people well. not to just do procedures. and that is the key to really transforming medicare. >> all right. i want to show you a map of the states that are refusing to implement the insurance exchanges. it's rather interesting. the other states are either implementing the exchanges or haven't decided to do that. if states don't decide to do it and the federal government comes in and sets up the exchange, isn't that kind of a win for the move toward universal health care someday because that infrastructure will be there? >> well, i think it provides people an option whether governors are refusing or not. that's the most important thing so they can get acce